title: Oncological outcomes of robotic-assisted radical prostatectomy after more than 5 years.
abstract: BACKGROUND
  In the last 10 years, robotic-assisted radical prostatectomy (RARP) has become increasingly popular as witnessed by an increased number of publications. However, there is still little known about the long-term oncologic outcomes of this technique. The aim of this study is to assess the oncologic outcomes of patients who underwent RARP at least 5 years ago, with an emphasis on biochemical recurrence-free survival (BCRFS).
  
  
  METHODS
  In 2004, RARP was introduced at our institutions. Records of all patients having RARP were prospectively collected in a dedicated database as part of the NUVOLA-BAUS project. For the present study, we selected only patients who had a follow-up of at least 5 years. Endpoints were BCRFS rate and 5-year cancer-specific survival (CSS).
  
  
  RESULTS
  Overall, we identified 175 patients; 61.7 % of patients had Gleason 7-9 disease and 26.9 % had pT ≥ 3 disease at final pathology. Eight patients (4.5 %) had biochemical recurrence at follow-up. Overall 5-year BCRFS rate was 95.4 %, while it was 97.6, 91 and 50 % in pT2, pT3 and pT4 diseases, respectively. Among the patients who recurred, the mean time to recurrence was 22.1 ± 8.8 months. These patients received salvage external beam radiation treatment combined with hormonal therapy (anti-androgen + LHRH analogue) or hormonal therapy alone. 5-year CSS was 98.3 % (172/175): in 2 cases, the specimen showed pT4 cancer, while lymph node metastasis was noted in one case.
  
  
  CONCLUSIONS
  The 5-year BCRFS and CSS after RARP are encouraging even in a population with significant high-risk disease.
authors.affiliation: Department of Urology, Guy's and St. Thomas' Hospitals NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, UK, mitchuro@gmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Billia
authors.forename: Oussama
authors.initials: O
authors.lastname: Elhage
authors.forename: Benjamin
authors.initials: B
authors.lastname: Challacombe
authors.forename: Declan
authors.initials: D
authors.lastname: Cahill
authors.forename: Rick
authors.initials: R
authors.lastname: Popert
authors.forename: Kathy
authors.initials: K
authors.lastname: Holmes
authors.forename: Roger Sinclair
authors.initials: RS
authors.lastname: Kirby
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome